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Published on: November 29, 2024
Diabetes and the risk of heart failure
Ravi Dhingra1, Ramachandran S Vasan
1Section of Cardiology, Heart and Vascular Center, Dartmouth Hitchcock Medical Center, One Medical Center Drive, Lebanon, NH 03756, USA.
Insights
Diabetes and heart failure are rising globally. This review explores how diabetes, even before onset, contributes to heart failure through biochemical changes, impacting cardiac function.
Area of Science:
- Cardiology
- Endocrinology
- Metabolic Diseases
Background:
- Global prevalence of diabetes and heart failure is increasing.
- Diabetes independently elevates heart failure risk, irrespective of traditional factors.
- Diabetic cardiomyopathy, characterized by diastolic dysfunction, is a significant concern.
Purpose of the Study:
- To review epidemiologic data on heart failure in diabetic and prediabetic states.
- To describe key mechanistic pathways linking diabetes to heart failure.
- To highlight molecular and biochemical changes contributing to cardiac dysfunction.
Main Methods:
- Literature review of epidemiologic studies.
- Synthesis of current research on diabetes-related cardiac pathophysiology.
- Analysis of molecular and biochemical alterations in diabetic hearts.
Main Results:
- Diabetes significantly increases heart failure risk.
- Biochemical and molecular changes in diabetes can lead to diastolic dysfunction.
- These detrimental changes may manifest even in prediabetic states.
Conclusions:
- Prediabetes and diabetes are critical risk factors for heart failure.
- Understanding the mechanistic pathways is crucial for prevention and treatment.
- Early detection and intervention in prediabetic individuals may mitigate cardiac risk.
Abstract:
Prevalence of diabetes and heart failure are increasing exponentially worldwide. Diabetes is well-known to increase the risk of heart failure independent of other traditional risk factors and ischemia. Current evidence indicates the presence of several biochemical and molecular changes associated with diabetes that lead to diastolic dysfunction or American Heart Association stage B heart failure. Some, if not all, changes may also predate the development of frank diabetes. In this review, the authors present some of the epidemiologic evidence and a brief description of major mechanistic pathways that favor the development of heart failure in prediabetic and diabetic states.
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